Pulmonary rehabilitation of COPD patients in primary care - pilot survey in two Norwegian municipalities

Background: Pulmonary rehabilitation (PR) is an essential part of the treatment for patients with COPD, but there are few adapted services in the primary health service in Norway. Objective: To test whether a Danish model for PR for COPD is transferable to the Norwegian primary health care system. Design: Simple observational study. Method: In nursing homes in two municipalities, a low threshold PR program led by local GPs, two physiotherapists and a nurse was established. Patients were recruited by their own GPs. Patients were examined before, immediately after and three months post intervention. Training outcome measures were physical capacity (Incremental Shuttle Walk Test; ISWT), burden of symptoms and quality of life; Clinical COPD Questionnaire (CCQ), COPD Assessement Test (CAT). Material: 36 patients (average age 70.5 years; 17 women) of whom 72% had very severe COPD. Results: After eight weeks, ISWT results were improved in 74.3% of participants. Corrected for cluster effects of repeated measurements at patient level, participants scored significantly better after eight weeks on all measurements. Three months later, most training effects had subsided. Conclusion: The Danish model was transferable to primary health care service in Norway. Most patients had benefits from the program, but the effects were short-lived. To maintain achieved improvements, follow up with continued training is needed after PR